Evaluation of the effect of antibiotics used during parenteral nutrition treatment on Candidemia

Abstract

OBJECTIVE: Parenteral nutrition is an important risk factor for candidemia. In this risk analysis study, the effect of previous antibiotic administration apart from the length of hospital stay, duration of Parenteral nutrition treatment, and Candida score parameters on developing candidemia was evaluated in the non-neutropenic patients receiving Parenteral nutrition treatment. METHODS: In this double center, retrospective, and cross-sectional study, the data of patients who received Parenteral nutrition treatment were collected. Patients with or without candidemia after the initiation of Parenteral nutrition treatment were compared in terms of demographic features, Candida score, length of hospital stay, duration of Parenteral nutrition treatment, and previous use of antibiotics.Then, predictor factors affecting the probability of candidemia during Candida growth time were determined by the Cox regression analysis.RESULTS: A total of 148 patients (59.5% males) were included and 16 (10.81%) of these had candidemia after initiation of parenteral nutrition treatment. The median (min-max) duration of parenteral nutrition treatment was 11 (4-72) days and the Candida growth time was 13 (7-29) days. Statistically significant differences were found between patients with or without candidemia groups in terms of length of hospital stay (p<0.001), duration of parenteral nutrition treatment (p<0.001), and Candida score (p<0.001). To determine the effect of these variables and antibiotics on candidemia, length of hospital stay [Hazard Ratio 1.030; p=0.021] and piperacillin-tazobactam (Hazard Ratio 5.626; p=0.030) were found significant and independent risk factors on the development of candidemia.CONCLUSION: There are some well-known risk factors including length of hospital stay, duration of Parenteral nutrition treatment, and Candida score; the potential impact of piperacillin-tazobactam administration should also be considered since they may be effective on the development of candidemia.

Invasive Candidiasis in Patients with Solid Tumors: A Single-Center Retrospective Study

“…The results of two multicenter prospective controlled clinical trials show that total parenteral nutrition is an independent risk factor for candidiasis. 24 , 25 Although there is no direct literature proving that the death rate of solid tumors patients with ICs will increase when they stay in the ICU during hospitalization, there are studies proving that the prolonged stay in the ICU will lead to the risk of invasive candidiasis. 21 , 26 Perhaps this is one of the reasons for the increase in mortality.…”